To intern in a government hospital is, when you’re fortunate enough to wake up from a few hours of sleep, to be met with a barrage of patients, each with his or her own entourage, and all members of the entourage wildly, loudly clamouring that their patient be given treatment first. As the sleeping hours become shorter and the clamour becomes louder, heated debates between a physician and a relative is often a common emergency room scene. Going into this profession, I promised myself that I will exert whatever self-control I possess to not be callous and uncouth. Yet each day is a struggle, and some days I lose.
Six weeks in a community rotation, where twenty four to thirty six hour duties are vague, wishy-washy ghosts of empirical Manila, was a welcome reprieve. Though it is a slight inconvenience to draw water for each bath and chore requiring the liquid gold, it was a small price to pay for tranquillity. Despite the fact that we walk along dirt roads for forty minutes to an hour to reach patients’ homes or health centers where we conduct clinical work, I find myself wishing that the minutes were longer, that day not turn to night as fast as it did. Though we provided no dramatic denouement in the health landscape, each case attended to meant resources saved, one less complication in the ER, one less argument at two o’clock in the morning, one family spared from anxiety, and one life liberated from risk.
A month and a half is too short for one to fully comprehend the intricacies of principles of grassroots organization, community and preventive medicine, and all its economic and political implications. What it did teach me, however, was the understanding of where my patients were coming from. The community was home to people who lived simple lives – farmers, fishermen, jeepney drivers, vendors, housekeepers, and the unemployed. Each day’s labor translated into the night’s meal, and little, if any, is saved for emergencies. For them to scrounge up whatever extra resources there are, to borrow from neighbours who do not have all that much to give, to travel in unlit, unevenly paved highways, for the sole purpose of seeking medical care for a parent, a brother, a sister, or a child – only to be met at the door, with little or rushed explanation, or one that would sound foreign to high school undergraduate ears – I would be frustrated too. In a a couple of days, I will once again push stretchers along the hallowed halls of that dear, understaffed and undersupplied government hospital. The day will continue to remain a struggle, but just maybe, there will be more days where I win.